Checklist for a Complete Application
A Complete Application
We will require ALL of the following from you for a complete application. Please have your complete application to us at least eight (8) weeks prior to your event. While we will accept applications closer to the event date (fees increase as we get closer to that date), we will not accredit two weeks prior to an event.
Also, please note that if family physicians are part of your participant group, Dr. Michael Fleming [michael.fleming@dal.ca] must be a corresponding member of your planning committee.
A checklist is also included in the application form.
- FP = Family physicians only
- SP = Specialist only
- BOTH = Family physicians and specialists at the same event
- ALL = alll of the above
ALL |
Completed and signed/dated accreditation application. |
ALL |
Budget for event (if no budget, a statement to that effect) NOTE: the budget should include the accreditation fee and the cost for participants (or a statement that there is no such cost). |
ALL |
Objectives for the event/program (can be indicated on page 3 of application). NOTE: These should include some non-medical expert CanMEDS competencies and a needs assessment. Should be a minimum of three. (Sometimes a program has overarching objectives as well as specific objectives for each part. We require all objectives be submitted.) |
ALL |
Draft agenda/program giving timing for all events, names of speakers and titles NOTE: The draft should include: the CPD logo, the draft credit statement (this is available at the end of the application form and in the policy document); the approval/co-sponsorship statement; NO logos from sponsors (and nothing that mimics the sponsors’ logos). |
ALL |
Planning Committee Member Confirmation forms for all physicians in the planning committee NOTE: If FPs are involved, Dr. Fleming must also be a corresponding member of the planning committee but he does not need to complete this form. (The CPDME OFfice already has his form on file.) |
| ALL |
Conflict of interest forms (signed and filled in) from all members of the planning committee (except for the administrative people involved), speakers, moderators, facilitators, and authors.* NOTE: Please return only the last two pages – first two are information only. |
SP |
Physician Organization Agreement form – signed and dated by Department Head |
FP or BOTH |
Co-Sponsorship Agreement form – signed and dated by Department Head |
SP |
Approval Agreement form – signed and dated by the planning committee chairperson |
ALL |
Declaration of Financial Sponsorship - signed by planning committee chairperson NOTE: please indicate thetype of sponroship (see the initials below the table) and the actual amount of funding. |
ALL |
Copy of the evaluation form NOTE: the bias question MUST be present (details regarding the format can be found on the application form or policy) |
ALL |
National Standard Acceptance form – signed and dated by planning committee chair |
ALL |
Sample of communcation with speakers (Please send a copy of your letter/email correspondence) NOTE: Please see the policy for details on what topics should be included in this communication |
Sect 3 only |
For Royal College Specialists only. All of the above as for specialists PLUS an appropriate Section 3 application completed and signed. |
All of the above are required for a complete application to go forward for accreditation.
Each application form has a checklist near the end listing all the materials required for accreditation. If items form that list are missing from the application package, we will follow up with you to get them.
*The COI forms for speakers/presenters can come after the accreditation letter is issued but are required PRIOR to the event. Our preference: include them as part of the application package.